烧伤创面不动杆菌的分离及耐药性分析

The isolation of acinetobacter strain from burn wound and the analysis of its antibiotic resistance

目的 了解烧伤患者创面不动杆菌的分布及耐药特征。 方法 用常规方法分离鉴定1999～ 2 0 0 3年笔者单位住院烧伤患者创面中的不动杆菌细菌株 ,根据美国国家临床实验室标准委员会 (NCCLS)标准 ,测定细菌耐药谱及耐药酶。 结果 从烧伤创面分离出不动杆菌 6 9株 ,其中鲍曼不动杆菌 5 2株 ,占 75 .36 % ;不动杆菌对 17种抗菌药物有较高的耐药率 ,其中产酶菌株的耐药率较高 ,平均为 6 8.2 5 % ;不产酶菌株耐药率较低 ,为 2 0 .33%。 38株产酶菌株中产AmpCβ内酰胺酶 (AmpCBLA)菌株占 4 2 .10 %。不动杆菌呈多重耐药 ,耐药的主要原因是产生各种 β内酰胺酶。 结论 不动杆菌是引起烧伤患者创面感染的主要致病菌之一 ,加强不动杆菌的分离鉴定并准确测定其耐药性 ,是临床合理应用抗生素的重要依据。

Objective To investigate the distribution and drug resistance of acinetobacter isolated from burn wounds. Methods The acinetobacter strains were isolated and identified by routine methods. Based on the recommendation of NCCLS, AmpC enzyme was determined by cefoxiti three-dimensional test, ESBLs by disk diffusion method and bacterial susceptibility by Kirby-Bauer agar diffusion method. ResultsAmong the 69 strains of acinetobacter clinically isolated from burn wounds, 52 were baumannii ( 75.6% ). The acinetobacter strains were identified to be highly resistant to 17 kinds of antibiotics. The drug resistance rate of β-lactamase-producing strains (68.25%) was higher than that of non-β-lactamase-producing strains (20.33%). The strains isolated in our burn ward exhibited multiple drug resistance which was mainly due to the production of many kinds of β-lactamases. Among the 38 strains of β-lactamase-producing acinetobacter, those producing AmpC β-lactamase (AmpC BLA) accounted for 42.1%.ConclusionAcinetobacter strain was one of the pathogens in burn wound infection, and its isolation and identification of its drug resistance could be beneficial to the doctors to make right choice of antibiotics.